成人EB病毒相关淋巴细胞增殖病克隆性转化的研究

发布时间：2018-11-26 07:42

【摘要】：目的:探讨成人EB病毒相关淋巴细胞克隆性转化的实验方法,为EB病毒相关淋巴细胞增殖病的早期诊断、分类、预测转归提供客观的判断指标。方法:采集5例成人EB病毒相关的淋巴组织增殖性疾病(EBV+LPD)患者的外周血标本,另采集4例成人传染性单核细胞增多症(IM)外周血标本作为阴性对照,3例急性NK细胞白血病(ANKL)的外周血标本作为阳性对照。应用流式细胞术(FCM)检测淋巴细胞免疫表型、RT-PCR检测T细胞受体(TCR)基因重排,Southern blot方法鉴定EBV末端重复序列(TR)多态性,对患者外周淋巴细胞进行了克隆性分析。结果:在5例EBV-LPD患者中,FCM仅检测出1例TCRVβ表型呈克隆性;RT-PCR检测TCRVβ时在IM患者均检测出TCR受体基因重排阳性,在5例EBV-LPD患者中检测出4例阳性;在5例EBV+LPD患者中1例检测有单克隆条带,2例检测有寡克隆条带。结论:流式细胞术表型分析的敏感性较差;TCRVβ重排不能区分反应性克隆和转化型克隆;而EB病毒末端重复序列克隆性鉴定的方法,能够更客观特异地反应EB病毒相关淋巴细胞增殖的克隆性转化,有助于改善疾病的早期诊断、分类及预测临床转归。
[Abstract]:Objective: to investigate the experimental method of clonal transformation of adult EB virus-associated lymphocytes in order to provide an objective index for the early diagnosis, classification and prognosis of EB virus-associated lymphoproliferative disease. Methods: peripheral blood samples of 5 adult patients with EB virus-associated lymphoproliferative disease (EBV LPD) and 4 adult infectious mononucleosis (IM) peripheral blood samples were collected as negative control. Peripheral blood samples from 3 patients with acute NK cell leukemia (ANKL) were used as positive control. The lymphocyte immunophenotype was detected by flow cytometry (FCM), and the (TR) polymorphism at the end of EBV was identified by RT-PCR analysis of T cell receptor (TCR) gene rearrangement, Southern blot. The clonal analysis of peripheral lymphocytes was carried out. Results: in 5 cases of EBV-LPD, only 1 case of TCRV 尾 was detected in FCM, TCRV 尾 was detected in all cases of IM by RT-PCR, and 4 cases were positive in 5 cases of EBV-LPD. Monoclonal bands and oligoclonal bands were detected in 1 of 5 patients with EBV LPD. Conclusion: the sensitivity of phenotypic analysis by flow cytometry is poor, and TCRV 尾 rearrangement can not distinguish reactive clone from transformed clone. The clone identification method of terminal repeat sequence of EB virus can more objectively and specifically reflect the clonal transformation of lymphocyte proliferation associated with EB virus, which is helpful to improve the early diagnosis, classification and prediction of clinical outcome of EB virus.
【作者单位】： 北京大学深圳医院血液内科;
【分类号】：R55

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